The effectiveness of virtual reality–assisted relaxation therapy in improving psychological symptoms and fatigue of breast cancer survivors: a systematic review and meta-analysis
- 1The Second Affiliated Hospital of Chongqing Medical University
Abstract
Objective: This meta-analysis investigated the effect of virtual reality–assisted relaxation therapy (VR-ART) on the reduction of psychological symptoms and fatigue in breast cancer survivors.
Methods: This review followed PRISMA 2020 reporting guidelines. We searched 9 bibliographic databases, plus ClinicalTrials.gov, WHO ICTRP, and GreyGuide, for records published from database inception through September 2026, limited to Chinese- and English-language publications. Backward and forward citation chasing of included studies and related reviews was completed via Web of Science to identify additional eligible records. Parallel-group RCTs evaluating VR-assisted relaxation therapy on psychological symptoms (anxiety, depression, psychological distress) and cancer-related fatigue among breast cancer survivors were included. Two reviewers independently assessed trial risk of bias using the Cochrane RoB 2 tool.
Results: Ten RCTs with 995 breast cancer survivors were included. Pooled estimates showed VR-ART yielded statistically significant reductions in anxiety (SMD = −1.94, 95% CI [−2.49, −1.40]; P < 0.001), depressive symptoms (SMD = −1.11, 95% CI [−1.36, −0.87]; P < 0.001), and psychological distress (MD = −1.33, 95% CI [−1.99, −0.67]; P = 0.005) versus controls. effect sizes varied across treatment stages; heterogeneity for anxiety and psychological distress disappeared among trials in active treatment stages; heterogeneity for anxiety and psychological distress disappeared among trials in active treatment stages (anxiety: P = 0.91, I² = 0%; psychological distress: P = 0.79, I² = 0%). Combining sensitivity analysis and existing research, we hypothesized that the combination of chemotherapy regimen and VR interactivity might be associated with variability in effect sizes for psychological distress (P = 0.96, I² = 0%); this observation was exploratory and hypothesis-generating only. Fatigue was synthesized qualitatively rather than pooled quantitatively due to high heterogeneity, with studies reporting reduced self-reported fatigue.
Conclusion: VR-ART was associated with statistically significant reductions in anxiety, depression, psychological distress, and cancer-related fatigue among breast cancer survivors. Based on findings from exploratory subgroup analyses, we speculated that intervention timing, VR interactivity, and concurrent chemotherapy status might influence the magnitude of intervention effects. Formal testing remains absent, and further research is required to develop individualized intervention strategies and optimize treatment responses.
Systematic review registration: https://www.crd.york.ac.uk/PROSPERO/ , identifier CRD420251114925.
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BibTeX
@article{deng2026effectiveness,
title = {{The effectiveness of virtual reality–assisted relaxation therapy in improving psychological symptoms and fatigue of breast cancer survivors: a systematic review and meta-analysis}},
author = {Yu Deng and Ying Chen and Jiangling Mo and Yinyin Liang and Sijie Yu and Xue Bai},
journal = {Frontiers in Oncology},
year = {2026},
month = oct,
doi = {10.3389/fonc.2026.1927287},
url = {https://www.frontiersin.org/articles/10.3389/fonc.2026.1927287/full},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - The effectiveness of virtual reality–assisted relaxation therapy in improving psychological symptoms and fatigue of breast cancer survivors: a systematic review and meta-analysis
AU - Yu Deng
AU - Ying Chen
AU - Jiangling Mo
AU - Yinyin Liang
AU - Sijie Yu
AU - Xue Bai
PY - 2026
DA - 2026/10/23
JO - Frontiers in Oncology
DO - 10.3389/fonc.2026.1927287
UR - https://www.frontiersin.org/articles/10.3389/fonc.2026.1927287/full
AB - Objective: This meta-analysis investigated the effect of virtual reality–assisted relaxation therapy (VR-ART) on the reduction of psychological symptoms and fatigue in breast cancer survivors. Methods: This review followed PRISMA 2020 reporting guidelines. We searched 9 bibliographic databases, plus ClinicalTrials.gov, WHO ICTRP, and GreyGuide, for records published from database inception through September 2026, limited to Chinese- and English-language publications. Backward and forward citation chasing of included studies and related reviews was completed via Web of Science to identify additional eligible records. Parallel-group RCTs evaluating VR-assisted relaxation therapy on psychological symptoms (anxiety, depression, psychological distress) and cancer-related fatigue among breast cancer survivors were included. Two reviewers independently assessed trial risk of bias using the Cochrane RoB 2 tool. Results: Ten RCTs with 995 breast cancer survivors were included. Pooled estimates showed VR-ART yielded statistically significant reductions in anxiety (SMD = −1.94, 95% CI [−2.49, −1.40]; P < 0.001), depressive symptoms (SMD = −1.11, 95% CI [−1.36, −0.87]; P < 0.001), and psychological distress (MD = −1.33, 95% CI [−1.99, −0.67]; P = 0.005) versus controls. effect sizes varied across treatment stages; heterogeneity for anxiety and psychological distress disappeared among trials in active treatment stages; heterogeneity for anxiety and psychological distress disappeared among trials in active treatment stages (anxiety: P = 0.91, I² = 0%; psychological distress: P = 0.79, I² = 0%). Combining sensitivity analysis and existing research, we hypothesized that the combination of chemotherapy regimen and VR interactivity might be associated with variability in effect sizes for psychological distress (P = 0.96, I² = 0%); this observation was exploratory and hypothesis-generating only. Fatigue was synthesized qualitatively rather than pooled quantitatively due to high heterogeneity, with studies reporting reduced self-reported fatigue. Conclusion: VR-ART was associated with statistically significant reductions in anxiety, depression, psychological distress, and cancer-related fatigue among breast cancer survivors. Based on findings from exploratory subgroup analyses, we speculated that intervention timing, VR interactivity, and concurrent chemotherapy status might influence the magnitude of intervention effects. Formal testing remains absent, and further research is required to develop individualized intervention strategies and optimize treatment responses. Systematic review registration: https://www.crd.york.ac.uk/PROSPERO/ , identifier CRD420251114925.
SN - 2234-943X
ER -